Treatment of reticular and telangiectatic leg veins: double-blind, prospective comparative trial of polidocanol and hypertonic saline

Dermatol Surg. 2012 Aug;38(8):1322-30. doi: 10.1111/j.1524-4725.2012.02422.x. Epub 2012 May 23.

Abstract

Background: Sixty-three subjects' legs were randomized to receive treatment with polidocanol (POL) or hypertonic saline (HS) for telangiectasias and reticular leg veins.

Objective: To compare the safety and efficacy of two sclerosing agents in three dermatologic surgery practices.

Methods: After exclusion of saphenofemoral junction incompetence, each subject's veins were categorized (telangiectasias <1 mm and reticular veins 1-3 mm) and randomized. Telangiectasias were treated with POL 0.5% or 11.7% HS and reticular veins with POL 1% or 23.4% HS. An independent, blinded physician determined efficacy and adverse events. Subject satisfaction questionnaires were administered and global clinical improvement assessments performed.

Results: All patients completed four visits at 0, 1, 4, and 12 weeks. Patients reported significantly greater pain during treatment with HS (2.42) than POL (1.03) (p < .001). There were no significant differences in physician-assessed improvement of reticular leg veins or telangiectasias; subject- or physician-assessed overall improvement; or physician-assessed phlebitis, pigmentation, edema, or matting in either of the three practices or the entire cohort. Two subjects developed ulcerations with HS. No ulcerations or allergic reactions developed after POL injections.

Conclusion: Both agents provided effective treatment, but HS caused 2.35 times as much pain during injections and resulted in two episodes of tissue necrosis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Double-Blind Method
  • Female
  • Humans
  • Leg / blood supply*
  • Male
  • Middle Aged
  • Polidocanol
  • Polyethylene Glycols / therapeutic use*
  • Saline Solution, Hypertonic / therapeutic use*
  • Sclerosing Solutions / therapeutic use*
  • Sclerotherapy*
  • Telangiectasis / pathology
  • Telangiectasis / therapy*
  • Veins / pathology

Substances

  • Saline Solution, Hypertonic
  • Sclerosing Solutions
  • Polidocanol
  • Polyethylene Glycols